Provider Demographics
NPI:1003291816
Name:SCHUBERT, MOLLY (MS CCC)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:SCHUBERT
Suffix:
Gender:F
Credentials:MS CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 BLALOCK RD STE 170
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6447
Mailing Address - Country:US
Mailing Address - Phone:713-468-0300
Mailing Address - Fax:713-468-0336
Practice Address - Street 1:1240 BLALOCK RD STE 170
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6447
Practice Address - Country:US
Practice Address - Phone:713-468-0300
Practice Address - Fax:713-468-0336
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110496235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist